Association of serum YKL-40 levels with the presence and severity of coronary artery disease in patients with obstructive sleep apnea syndrome

Abstract

Purpose: Current evidence supports a robust association between obstructive sleep apnea syndrome (OSAS) and the risk of coronary artery disease (CAD). YKL-40, a 40 kDa heparin- and chitin-binding glycoprotein, is found to be associated with the presence of CAD. This study aims to examine the association of serum levels of YKL-40 with the presence and severity of CAD in patients with OSAS. Methods: A total of 246 patients with OSAS who underwent coronary angiography for the evaluation of CAD (134 patients with CAD and 112 patients without CAD) were enrolled in this study. The severity of CAD was assessed using the coronary atherosclerosis index (CAI). Serum levels of YKL-40 were determined using enzyme-linked immunosorbent assay. Results: Serum YKL-40 levels were significantly higher in OSAS patients with CAD compared with those without CAD. Multivariable logistic regression analysis revealed that serum YKL-40 levels were an independent determinant of the presence of CAD in patients with OSAS. In addition, Spearman correlation analysis showed that serum YKL-40 levels were positively correlated with CAI in OSAS patients with CAD. Patients with statin treatment showed significantly lower levels of serum YKL-40 compared with those without. Conclusions: Elevated levels of serum YKL-40 are associated with the presence and severity of CAD in patients with OSAS.

Atherosclerosis is exacerbated by chitinase-3-like-1 in amyloid precursor protein transgenic mice

“…In addition, the results from recent studies on human subjects have suggested that chitinase-3-like protein 1 (Chi3l1), also termed YKL-40, might serve as a potential biomarker in the blood plasma and cerebrospinal fluid for AD diagnosis 24 - 29 . Furthermore, recent studies have reported that the expression level of Chi3l1 is increased in atherosclerotic aorta 30 , 31 and have demonstrated that increased plasma Chi3l1 is associated with endothelial dysfunction 32 , 33 and thromboembolic stroke 34 and have suggested Chi3l1 as a diagnostic marker for cardiovascular diseases 35 - 37 , whereas knockdown of Chi3l1 in ApoE -/- mice suppresses atherosclerotic plaque progression 30 and abdominal aortic aneurysm (AAA) development 38 .…”

Serum YKL-40 levels as a prognostic factor in patients with intracerebral hemorrhage

“…Recently, it has been shown that YKL-40 is expressed by monocytes/macrophages in peripheral blood and synovial tissue [27][28][29][30][31]. Although the exact physiological function of YKL-40 is unknown, the results of clinical studies in community-acquired pneumonia, active rheumatoid arthritis, hepatic fibrosis, breast cancer, colorectal cancer, and human glioma have disclosed that serum levels of YKL-40 are correlated with the severity of disease [5][6][7][8][9][10][11][12][13]. Moreover, high levels of YKL-40 in serum and cerebrospinal fluid independently predict death in patients with pneumococcal bacteremia and purulent meningitis, respectively [14,15].…”

“…A positive correlation between the severity of the disease state and the levels of YKL-40 in either cerebrospinal fluid or sera of patients with a variety of pathological conditions has been demonstrated in the recent clinical studies, and most have speculated that YKL-40 might be a valuable biochemical marker of inflammation, similar to C-reactive protein [5][6][7][8][9][10][11][12][13][14][15]. YKL-40 can also be expressed in astrocytes and may take part in acute neuroinflammation [16][17][18].…”

Association of Serum YKL-40 With the Presence and Severity of Obstructive Sleep Apnea Syndrome

“…20 This suggests that serum YKL-40 levels could also be utilized to predict the development of CAD in OSAS patients.…”